CAJ | 학술논문

目的：探讨腹横肌平面阻滞在腹壁皮瓣乳腺癌患者乳房再造术后镇痛的临床效果。方法回顾性分析腹横肌平面阻滞置管间断注射局部麻醉药术后镇痛和术后患者自控静脉镇痛48 h 镇痛效果、阿片类药物的使用量及术后镇痛相关并发症的发生率。结果腹横肌平面阻滞组术后镇痛效果与患者自控静脉镇痛组相当，但阿片类药物使用量和术后镇痛相关并发症发生率却远低于患者自控静脉镇痛组。结论腹壁皮瓣乳腺癌患者乳房再造术后应用腹横肌平面阻滞置管镇痛可提供与传统术后镇痛方法相当的镇痛效果，同时又具有传统术后镇痛方法所不具备的优势，值得临床应用。
목적：탐토복횡기평면조체재복벽피판유선암환자유방재조술후진통적림상효과。방법회고성분석복횡기평면조체치관간단주사국부마취약술후진통화술후환자자공정맥진통48 h 진통효과、아편류약물적사용량급술후진통상관병발증적발생솔。결과복횡기평면조체조술후진통효과여환자자공정맥진통조상당，단아편류약물사용량화술후진통상관병발증발생솔각원저우환자자공정맥진통조。결론복벽피판유선암환자유방재조술후응용복횡기평면조체치관진통가제공여전통술후진통방법상당적진통효과，동시우구유전통술후진통방법소불구비적우세，치득림상응용。
Objective To explore the application of postoperative multimodal analgesia of transversus abdominis plane block in breast reconstruction using the muscle-sparing transversus abdominus myocutaneous flaps.Meth-ods This study is a retrospective analysis designed to test the effectiveness of a transversus abdominis plane catheter delivering intermittent local anesthetic and patient controlled intravenous analgesia in reducing postoperative ab-dominal pain following abdominal tissue breast reconstruction.The objective of this study is to compare the mean total opioid consumption,visual analogue score and the incidence of postoperative analgesia related complications in the first postoperative 48 hours between the two groups.Results The analgesic effect of two groups is almost the same,but the total opioid consumption and incidence of postoperative analgesia related complications of transversus abdominis plane group is lower than patient controlled intravenous analgesia group.Conclusion The postoperative analgesia of breast reconstruction using the muscle-sparing transversus abdominus myocutaneous flaps by trans-versus abdominis plane catheter could provide the same analgesic effect to traditional postoperative analgesia meth-ods.It can provide some advantage which traditional postoperative analgesia can′t,and can be applied in the clinical work.